In May, I called to schedule my annual check-up with my primary care doctor. The first available appointment was in August — three to four months later. That was problem number one: why on earth does it take months to see the doctor who is supposed to be managing my overall health?
But that was just the beginning.
I wanted to make sure he walked into our visit fully informed. Over the past year, I’d seen providers and specialists in Palm Desert, California, Seattle, Washington, Sleepy Hollow, New York, Boston, Massachusetts and also with nationwide Amazon owned One Medical.
In this age of electronic medical records, I naively thought these institutions would simply share information. Wrong. Instead, I had to contact each one individually, sign medical release forms, and have them fax my records. Faxed — in 2025! The burden was entirely on me.
Next, I wanted to flag the important issues in advance so my doctor could prepare. I put together a list of 21 items I hoped we could review together. Weeks before the appointment, I:
- Briefed his medical assistant about my history and priorities.
- Submitted everything again through MyChart, writing directly to the doctor.
- Notified them that outside records were on the way.
In other words, I did everything possible to put the ball in their court.
Finally, I attached a carefully considered set of recommendations from Dr. Peter Attia, the physician and best-selling author known for his work on longevity and preventive health. For someone my age (81), his list included important evaluations: for example, a 14-day continuous glucose monitor, a high-sensitivity CRP test for inflammation, liver scans for fatty liver disease, and others. I wasn’t asking for blind obedience — only an informed discussion of their merits and how they might apply to me.
So when I walked into that exam room, I thought we’d be ready for a meaningful conversation.
Instead, here’s what I got:
- My doctor hadn’t read a single one of the outside records I worked so hard to have sent.
- He ignored the briefings from his medical assistant.
- He dismissed Dr. Attia’s recommendations outright, without explanation or discussion.
- And worst of all, he never touched my 21-item list — because my “annual check-up” had been scheduled for 30 minutes.
Thirty minutes for an annual check-up? You’ve got to be kidding me.
Later, I discovered another insult: Medicare makes a distinction between an “annual wellness visit” and an “annual physical.” The wellness visit is essentially a bureaucratic checklist, while the physical is what patients expect — a true, comprehensive evaluation. No one explained that to me in advance.
So What Are My Options?
Short of fixing the system itself, I see four possible paths for me:
- Find another primary care doctor. Maybe somewhere there’s a doctor who listens, prepares, and cares. But with waitlists and bureaucracy, that’s hardly guaranteed.
- Concierge medicine. For thousands of dollars a year, you can buy your way into more time and attention. But what does it say about our healthcare system when only the wealthy can afford truly personal care?
- Skip primary care altogether. Many people already do. They bounce from urgent care to specialists, never building a relationship with a doctor who sees the big picture. That feels risky, but at least you avoid the frustration.
- DIY (do it yourself) healthcare. This is where I increasingly find myself. I keep track of my far-flung network of specialists — cardiologists here, orthopedists there, providers in different cities. I use tools like ChatGPT for general advice, and I cobble together my own version of care, one appointment at a time. It’s exhausting, but sometimes it feels like the only way.
Here’s the larger issue. Our healthcare system is broken. If someone like me — who came prepared, organized, and proactive — can’t get his doctor to prepare, read, or even listen, then what chance does the average patient have?
We need a system where:
- Medical records actually follow us between providers.
- Doctors take time to review patient information before the visit.
- Preventive health recommendations are discussed, not dismissed.
- And annual visits are long enough to do more than scratch the surface.
- The medical reimbursement/insurance system is revised to encourage primary care physicians and internists to get appropriately reimbursed for their time just like the specialists do.
Until then, patients will leave appointments not reassured, but angry. And the sad truth is, more and more of us will be forced into one of those four imperfect options.
Bottom line. Frustrated and angry.
Neil I had to take the Concierge Cardiologist path that you listed. At a hefty cost of 5k a year I had his private number for use 24 hours a day. So not having had any issues of significance, I Paid 5k a year for just a couple of calls. But, if and when I needed an appointment I went to the top of the list and was able to get same day appointment. Yes I agree our system is broken and I share your frustration.
Linda and I have relatively inexpensive concierge primary care right here in the desert. Since we are here all year, all our doctors are in the Eisenhower system, (Save Linda’s go-to in Orange Co).
Since you solved a problem you saw in transportation with Flex Car, perhaps the solution to this problem is Flex Care.
In Canada, some is better, some is worse. Yesterday Liz had a couple of issues needing attention. She phoned our Family Dr who called her 5 hours later (we live an hour away and could have gone in for an on site visit) and she courteously listened for 20 minutes to Liz’s list, made suggestions and ensured she was referred to a specialist regarding a carotid artery ultrasounding that could take up to 2 months.as her case is deemed only semi urgent!
Me, I called my skin Dr for an appointment 2 days ago and got in yesterday for a couple of spots nitrogened off and one, he felt needs a referral to a plastic surgeon and I hope to hear from one in the next week or so—-not sure how long it will be to get in. What impressed me was he was able to pull up on his computer every medical visit hospitalization and procedure going back at least 5 years despite the fact I’ve been attended to by at least a dozen Dr’s/Specialists and had several procedures, basal cell etc. and over a dozen days of hospitalization for operations, broken ankle, broken ribs etc. No cost for any of this.
I remember when..no doctor was necessary, ah.. to be 20 or 30 40 once again!
Now it’s a blood test every year ..my primary physician retired….consequently I don’t like the idiots that you described..
You described exactly what I have experienced. Due to living in both NYC ( with doctors in two health systems that dont communicate) and in Colorado – again two systems just in Eagle County. I was ready to try to make the doctor who sees me in Urgent Care my primary, but he declined. You should send this to the NYTimes.
Neil: I have loved the Concierge route for 13 years, 10 years in Pasadena and three years in Newport Beach. You get 24 hour access— sometimes immediate, but always within two or three hours. $2000 per year, and I see him weekly. Insurance covers it all!
He can serve me when I have an emergency during travel: locates pharmacies and clinics in the most rural places if I’m in the USA.
Two weeks after my first physical with him (I moved from my beloved Pasadena Concierge to retire on Lido Isle, Newport Beach) I had emergency brain surgery and they network took care of it all— quarterbacked by my new concierge. It is so worth the money!
I now moved all my medical to the Hoag Hospital affiliated hospitals— they are all on a common system where all of my 12 specialists can get the latest detailed info and labs online—they all know each other and can share notes by phone when needed. I’m sure there are comparable hospital group setups in both Seattle and the Desert, and highly recommend this type of system with a Concierge quarterback. .
Neil, you’re lucky you got to see an MD. Many practices have you seen by a NP for screening and triage – I’m a former RN so I am not discounting their value, but the system is broken. My kids tell me that many younger gens don’t want to go into medicine incurring high debt after 10+ years of schooling to be overworked in a broken system. They become NPs and PAs to make decent money sooner, and have better quality of life. We haven’t even discussed surgery, Neil. Terry has had many – forget your primary MD – they don’t even come to see you; a revolving “on call” roster of hospital physicians make rounds and have no interest or background about you. Every hospitalized patient absolutely needs a personal advocate / family/ friend or risk being ignored (at best) or having some catastrophic incident from lack of communication. Meanwhile the insurance companies and big pharm are happy cats. Have you seen what they charge for a simple Tylenol in the hospital these days?